Atherosclerotic heart disease is a major source of cardiovascular morbidity and mortality in adult populations. To assess the prevalence of anatomical and functional abnormalities of the heart in such patients, we studied total 50 subjects with atherosclerotic heart disease by echocardiography and compared with 27 control subjects. We found significant change(p<0.05) of aortic root dimension, left ventricular mass, mitral valve E-F slope, E-point septal separation, and functional measurements show significant change in ejection fraction and fractional shortening of left ventricle. Characteristically, abnormal septal movement reveals in 70% of patients including paradoxical, flat & diminished, hyperactive motion, and among them paradoxical movement is the most frequent. Also left ventricular posterior wall movement is abnormal in 30% of the patient group. The prevalence of echocardiographic abnormalities is 80 percentile of total, which include 30 percentile subjects with only echocardiographic abnormalities without abnormality in 12-lead ECG, chest X-ray and laboratory findings. And these abnormalities can be detected well by echocardiography before they were otherwise apparent.
Adult ; Echocardiography* ; Electrocardiography ; Heart Diseases* ; Heart Ventricles ; Heart* ; Humans ; Mitral Valve ; Mortality ; Prevalence ; Thorax

Follow-up sonographic studies of three infants, whose initial sonograms showed findings suggestive of choledochal cyst, demonstrated disappearance of cystic dilatation of the common bile ducts. The phenomena could be accounted for by acute common bile duct obstruction secondary to bile sludge. Bile plug syndrome should also be included in the differencial diagnosis. When a cystic or fusiform dilatation of the common bile duct is seen on sonogram. Conservative management must be the choice of approach unless the finding is proven to unchanged over a period of time and irreversible.
Bile ; Choledochal Cyst ; Common Bile Duct* ; Diagnosis ; Dilatation* ; Follow-Up Studies ; Humans ; Infant* ; Sewage ; Ultrasonography

No abstract available.
Helicobacter pylori* ; Purpura, Thrombocytopenic, Idiopathic*

No abstract available.
Helicobacter pylori* ; Purpura, Thrombocytopenic, Idiopathic*

'Num-chin syndrome', isolated mental neuropathy, is a rare manifestaion of malignant hernatologic diseases, but important sign for early diagnosis and prediction of clinical course and prognosis. Here we report 7 cases of numb-chin syndrome; one in leukemic transformation of malignant lymphoma, one in blastic crisis of chronic myelogenous leukemia and 5 in acute leukemia Two cases of acute leukemia revealed the 'numb-chin sign' in early course of disease before the diagnosis of leukemia and other three in aggravating state of acute leukemia. The therapeutic response and prognosis was poor and 5 cases expired in a few months.
Diagnosis ; Early Diagnosis ; Hematologic Diseases* ; Leukemia ; Leukemia, Myelogenous, Chronic, BCR-ABL Positive ; Lymphoma ; Prognosis

"It was reported that polymorphism of TNF alpha gene was present in promoter region and involves the substitution of guanine by adenosine in the uncommon (TNFA 2) allele. In this study, we investigated the significance of TNFA gene polymorphism in relation to various clinical characteristics and autoantibody profiles in SLE as well as comparing it with that of other countries, and also studied its association with peripheral TNF-a production in vitro. TNFA genotyping was performed in 126 SLE patients and 300 controls using DNA extracted from peripheral leucocytes. The biallelic polymorphism at position -308 of the TNFA promotor was determined by Ncol- RFLP. Peripheral mononuclear cell production of TNF-a was investigated by bioassay using L-929 cell cytotoxicity. The TNFA ""1 homozygote was a predominant allele (77.0%) in SLE, which was not different from the controls. TNFA ""2 homozygate was extremely rare in both patients and controls (0.8%, 1.3% respectively). The clinical manifestations between TNFA '1 and TNFA""2 did not differ. The production of autoantibodies including dsDNA, anti-La, anti-nRNP and anti-Sm was not different between two alleles, whereas anti- Ro antibody was more frequent in TNFA""1/TNFA '1 than in TNFA'1/TNFA'2 (62.1% vs 38.4%, P=0.022). The polymorphism of TNFA gene did not influence the lipopolysaccharide stimulated peripheral mononuclear cell production of TNF-a (1356+/-293 vs 1119+/-385 pg/ml; TNFA'1/TNFA'1, TNFA'1/TNFA'2 respectively). These results suggested that promoter polymorphism of TNFA was not directly involved in the susceptibility of SLE and was not responsible for differential peripheral TNF-a production, but TNFA ' may be associated with anti-Ro antibody production."
Adenosine ; Alleles ; Autoantibodies ; Biological Assay ; DNA ; Guanine ; Homozygote ; Humans ; Lupus Erythematosus, Systemic* ; Polymorphism, Restriction Fragment Length ; Promoter Regions, Genetic ; Tumor Necrosis Factor-alpha*

BACKGROUND: Leukocytes, both polymorphonuclear leukocytes(PMNL) and monocytes/macrophages have been implicated in the pathogenesis of the cerebral ischemia and stroke. Neutrophils accumulate in post-hypoxic-ischemic neonatal rat brain prior to the evolution of necrosis and neutrophil depletion attenuates hypoxic-ischemic brain injury. However, the mechanisms leading to post-hypoxic-ischemic neutrophil accumulation are unknown yet. We hypothesized that Intercellular Adhesion Molecule-1 might mediate post-hypoxic-ischemic injury in the immature brain; thus, we evaluated ICAM-1 gene expression in post-hypoxic-ischemic neonatal(postnatal day 7) rat brain. METHODS: Neonatal rats(n=36) underwent right carotid ligation followed by exposure in 8% O2 for 2.5 hours; this procedure typically produces ipsilateral striatal, hippocampal and cortical infarction. Control groups are included by carotid ligation alone, hypoxia alone, and neither hypoxia nor ligation. For RNA extraction, rats were killed 0, 1, 2, 4, 8, 12, 24 and 48 h post- hypoxia-ischemia and RT-PCR was carried out. RESULTS: ICAM-1 mRNA was barely detected in the controls including normal and sham operated animals. In the cortex, striatum and hippocampus, ICAM-1 mRNA was significantly induced in the ipsilateral(right) side compared to the contralateral(left) side just after hypoxia-ischemia. The elevated ICAM-1 mRNA gradually reached a peak at 4 or 8 h and then decreased to an almost basal level by 24 to 48 h. In contrast, the less pronounced contralateral(left-sided) ICAM-1 mRNA expression appeared to peak earlier, within 2 h post-hypoxia-ischemia. CONCLUSION: The temporal profiles of post-hypoxic-ischemic ICAM-1 mRNA expression are consistent with a role in post-hypoxic-ischemic neutrophil recruitment and in the evolution of subsequent brain injury.
Animals ; Anoxia ; Brain Injuries* ; Brain Ischemia ; Brain* ; Gene Expression ; Hippocampus ; Infarction ; Intercellular Adhesion Molecule-1* ; Leukocytes ; Ligation ; Necrosis ; Neutrophil Infiltration ; Neutrophils ; Rats* ; RNA ; RNA, Messenger* ; Stroke

Granuloma is a chronic inflammatory process associated with non-infectious agents or infectious diseases such as tuberculosis. It is well known that AFB staining, which has been used to determine the etiology of the granulomatous inflammation, lacks both sensitivity and specificity. Due to the slow growth rate of most pathogenic mycobacteria, culturing of organisms can take up to eight weeks. It is not uncommon for specific therapy to be delayed, or for an inappropriate treatment be given to patients without mycobacterial infections or with infections caused by atypical mycobacteria. Determination of the causative agent in Papanicolaou stained cytology specimens gives pathologists even more difficulties when only necrotic material has been aspirated from the center of the granuloma. In recent years, the use of a polymerase chain reaction for the amplification of DNA has appeared promising in terms of speed, efficiency, sensitivity, and specificity. Since a polymerase chain reaction permits the sensitive genetic analysis of small amounts of tissue, it is ideally suited to the genetic analysis of cytologic specimens. A polymerase chain reaction is easily performed on unfixed and unstained cells, however, an analysis of ethanol fixed and Papanicolaou-stained archival smears has also been described. We have recently established a method to detect Mycobacterium tuberculosis organism by a nested polymerase chain reaction with primers in the insertion sequence IS 6110, using cellular digests of ethanol-fixed and Papanicolaou-stained archival specimens aspirated from the lymph nodes, lungs, thyroid, etc. Inhibitors present in Papanicolaou stained material was removed by destaining the slides with 0.5% HCl solution for 10-30 minutes. Eight out of ten cases which have shown the epithelioid granulomas revealed a positive reaction and four out of ten cases which have shown lymphohistiocytic cells in a necrotic background without any evidence of granuloma revealed a positive reaction. This study showed that it was possible to employ a polymerase chain reaction to detect Mycobacterium tuberculosis in Papanicolaou stained archival cytology specimens.
Communicable Diseases ; DNA* ; Ethanol ; Granuloma ; Humans ; Inflammation ; Lung ; Lymph Nodes ; Mycobacterium tuberculosis* ; Mycobacterium* ; Nontuberculous Mycobacteria ; Polymerase Chain Reaction ; Sensitivity and Specificity ; Thyroid Gland ; Tuberculosis

No abstract available.
Brain* ; Child* ; Humans ; Seizures*

PURPOSE: The purpose of this study was to analyze and clarify the ambiguous concept of DNR, and to distinguish between DNR and euthanasia. METHOD: This study used the process of Walker & Avant's concept analysis. RESULT: The definable attributes of DNR were care for comfort, no further treatment and no CPR. The antecedents of DNR were the autonomy of patients and families feelings about death, the uselessness of treatment and the right to die with dignity. The process of the DNR decision should be documented and the antecedents of DNR also can be a basis for objective standards of DNR decision-making. The result of DNR was the acceptance of death by patients and families. CONCLUSION: DNR is decided and documented by the antecedents of DNR, and the result is a natural acceptance of death, the last process of human life. Hospice care should be activated and nurses must be patient's advocates and families' supporters in the process.
*Attitude to Death ; Decision Making ; Family ; Hospice Care ; Humans ; *Resuscitation Orders